Osteoarthritis (OA) is the most common type of arthritis. Its high prevalence, especially in the elderly, and the high rate of disability related to disease make it a leading cause of disability in the elderly. Because of the aging of Western populations and because obesity, a major risk factor, are increasing in prevalence, the occurrence of osteoarthritis is on the rise. In the United States, osteoarthritis prevalence will increase from 66–100% by the year 2020.
OA affects certain joints, yet spares others (Fig. 326-1). Commonly affected joints include the cervical and lumbosacral spine, hip, knee, and first metatarsal phalangeal joint (MTP). In the hands, the distal and proximal interphalangeal joints and the base of the thumb are often affected. Usually spared are the wrist, elbow, and ankle. Our joints were designed in an evolutionary sense, when humans were still brachiating apes. We thus develop OA in joints that were ill designed for these tasks, i.e., joints involved in pincer grip in the hands and lower extremity weight-bearing joints. Some joints, like the ankles, may be spared because their articular cartilage may be uniquely resistant to loading stresses.
OA is joint failure, a disease in which all structures of the joint have undergone pathologic change, often in concert. The pathologic sine qua non of disease is hyaline articular cartilage loss, present in a focal and, initially, nonuniform manner. This is accompanied by increasing thickness and sclerosis of the subchondral bony plate, by outgrowth of osteophytes at the joint margin, by stretching of the articular capsule, by mild synovitis in many affected joints, and by weakness of muscles bridging the joint. In knees, meniscal degeneration is part of the disease. There are numerous pathways that lead to joint failure, but the initial step is often joint injury in the setting of a failure of protective mechanisms.
Osteoarthritis of The Knee
The Effect of Balneotherapy on Knee Osteoarthritis
The Genetics of Osteoarthritis
Pathophysiology of Osteoarthritis
Treatment of Osteoarthritis
Osteoarthritis in Active Persons
Ladder of Treatment for Knee Osteoarthritis
Osteoarthritis – ORTHOPEDIC RADIOGRAPHY:
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